• Title/Summary/Keyword: Acute Interstitial pneumonia

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Acute and Chronic Eosinophilic Pneumonia; Clinical and Laboratory Findings (급성 및 만성 호산구성 폐렴의 임상적 고찰)

  • Hyun, D.S.;Yeo, D.S.;Kim, J.W.;Lee, S.H.;Lee, S.Y.;Kim, S.C.;Seo, J.Y.;Song, S.H.;Kim, C.H.;Moon, H.S.;Song, J.S.;Park, S.H.
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.795-804
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    • 1998
  • Background: Chronic eosinophilic pneumonia(CEP) is interstitial lung disease characterized by multiple infiltration on radiographic study, accumulation of eosinophils in the alveolar space and interstitium of the lung, chronic persistent symptoms and possible relapse. Acute eosinophilic pneumonia(AEP) is a recently described illness, characterized by rapid clinical course, acute respiratory insufficiency and no relapse. Method : To better characterize acute and chronic eosinophilic pneumonia, we studied the clinical and laboratory features of 16 patients(AEP : 7 patients, CEP : 9 patients), which were clinico-pathohistologically diagnosed and not to be associated with organic disorders producing peripheral blood eosinophilia. Results: The mean age was higher for patients with CEP than for patients with AEP ($55.4{\pm}15.1$ vs. $24.6{\pm}7.9$ years, p<0.05). High fever(above $38^{\circ}C$) was presented in all patients of AEP and in one patient(11%) of CEP. All patients of AEP and eight patients (89%) of CEP showed bilateral pulmonary infiltrates, and 6 patients(86%) of AEP and 2 patients(22%) of CEP showed pleural effusion in chest radiograph. The mean white blood cell count of AEP and CEP were $17,186/mm^3$ and $12,867/mm^3$, respectively. The mean peripheral blood eosinophil count of AEP and CEP were $939/mm^3$ and $2,104/mm^3$, respectively. The mean eosinophil fraction of BAL fluid of AEP and CEP were 32.4% (range: 18~47%) and 35.8% (range: 15.3~88.2%), respectively. The mean $PaO_2$ was lower for patients with AEP than for patients with CEP ($44.1{\pm}15.5$ vs. $62.7{\pm}6.9$mmHg, p<0.05). All patients of AEP and CEP were initially treated with antibiotics. All patients of CEP and one patients of AEP were finally required systemic steroid therapy. 6 patients of AEP were improved without steroid therapy. Relapse was observed in 3 patients(33%) of CEP. Conclusion : Compair with of chronic eosinophilic pneumonia, acute eosinophilic pneumonia was characterized by relatively young age, acute onset, high fever, severe hypoxemia, diffuse pulmonary infiltrates with pleural effusion, steroid therapy is effective but spontaneous improvement with conservative therapy was frequent.

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Korean Guidelines for Diagnosis and Management of Interstitial Lung Diseases: Part 2. Idiopathic Pulmonary Fibrosis

  • Lee, Sang Hoon;Yeo, Yoomi;Kim, Tae-Hyung;Lee, Hong Lyeol;Lee, Jin Hwa;Park, Yong Bum;Park, Jong Sun;Kim, Yee Hyung;Song, Jin Woo;Jhun, Byung Woo;Kim, Hyun Jung;Park, Jinkyeong;Uh, Soo-Taek;Kim, Young Whan;Kim, Dong Soon;Park, Moo Suk;Korean Interstitial Lung Diseases Study Group
    • Tuberculosis and Respiratory Diseases
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    • v.82 no.2
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    • pp.102-117
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    • 2019
  • Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrosing interstitial pneumonia, which presents with a progressive worsening dyspnea, and thus a poor outcome. The members of the Korean Academy of Tuberculosis and Respiratory Diseases as well as the participating members of the Korea Interstitial Lung Disease Study Group drafted this clinical practice guideline for IPF management. This guideline includes a wide range of topics, including the epidemiology, pathogenesis, risk factors, clinical features, diagnosis, treatment, prognosis, and acute exacerbation of IPF in Korea. Additionally, we suggested the PICO for the use of pirfenidone and nintendanib and for lung transplantation for the treatment of patients with IPF through a systemic literature review using experts' help in conducting a meta-analysis. We recommend this guideline to physicians, other health care professionals, and government personnel in Korea, to facilitate the treatment of patients with IPF.

A Clinical Study of Mycoplasma Pneumoniae Pneumonia (소아 Mycoplasma Pneumoniae 폐렴의 임상적 고찰)

  • Kang, Mi-Hwa;Jun, Jin-Gon
    • Journal of Yeungnam Medical Science
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    • v.6 no.1
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    • pp.21-29
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    • 1989
  • A clinical study was made on 71cases of Mycoplasma pneumoniae pneumonia from March, 86 to February, 89. The results were as follows; 1. Among the 315 cases of pneumonia, the incidence of mycoplasmal infection was 22.5%. 2. The peak incidence of age was between 5 to 9years of age(53.5%). 3. The sex ratio of male to female was 1.3:1. 4. Monthly distribution showed relatively high frequency from October to January(59.2%). 5. Most common clinical symptoms were cough(98.6%)and then followed by fever(49.3%), coryza(19.7%). Rales were the most common finding(95.7%) and followed by pharyngeal injection (49.3%) and wheezing(18.3 %). 6. The leukocyte counts in peripheral blood were most common in the range of 5000-10000/$mm^3$(47.9%) and the ESR was increased in 57.7%, and positive CRP cases were 87.3%. 7. The most common radiologic finding of pulmonary infiltration was interstitial infiltration(45.1) and then followed by disseminated lobular(39.4%) and lobar pneumonia(15.5%). 8. There are a few cases associated disease or complication: otitis media (5.6%), hepatitis(4.2%) acute glomerulonephritis. bronchial asthma and sinusitis(2.8%), thrombocytopenia(1.4%).

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The Detection of Bovine Respiratory Syncytial Virus Using Immunohistochemistry and pathologic Findings (면역조직화학염색법을 이용한 소 합포체성 폐렴바이러스의 검출 및 병리학적 소견)

  • Yoon, Soon-Seek;Hwang, Eui-Kyung;Moon, Oun-Kyong;Bae, You-Chan;Kim, Jae-Hoon;Eom, Hyun-Jong;Cho, Jae-Jin;Jean, Young-Hwa;Choi, Sang-Ho
    • Korean Journal of Veterinary Pathology
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    • v.1 no.2
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    • pp.157-160
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    • 1997
  • Two 2 and 7 months-old holstin and one 3 months-old native Korean calf suffering from respiratory illness were submitted to the National Veterinary Research Institute for euthanasia and pathologic examination. At necropsy diffuse lobar pneumonia was present in apical cardiac and diaphragmatic lobes in all calves. Microscopically acute multifocal bronchiolitis and interstitial syncytial cell formation were frequently observed. in addition occlusion of bronchiolar lumen due to cellular proliferation and fibrosis accompanied by interlobular septal emphysema were also present. Immunohistochemically bovine respiratory syncytial virus antigen were positively identified in lung lesions including bronchial and bronchiolar epithelium alveolar macrophages and lymphocytes.

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A Case of Fulminant Bronchiolitis Obliterans Organizing Pneumonia (특발성 폐섬유화증과 감별진단을 요하는 전격성 폐쇄성 세기관지염 기질화 폐렴 (Fulminant Bronchiolitis Obliterans Organizing Pneumonia) 1예 보고)

  • Kim, Mi-Seon;Chang, Jung-Hyun;Kim, Tai-Hee;Cha, Ju-Hyun;Kim, Hae-Young;Sung, Sun-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.204-212
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    • 1998
  • Bronchiolitis obliterans organizing pneumonia(BOOP) is a type of diffuse interstitial lung disease that has emerged in the past decade as an important cause of acute respiratory illness in adult. Clinically, the entity usually starts with a subacute influenza-like illness, followed by cough, progressive dyspnea, and weight loss. Organized inflammatory polypoid materials predominantly affecting distal bronchioles, alveolar ducts, and peribronchial alveolar spaces are a key pathologic findings. BOOP is characterized by a good response to glucocorticoid and an excellent prognosis. However, there is a subset of BOOP who presents with a fulminant course leading to death or chronic severe fibrosis with marked impairment of lung function. Recently, we have experienced a case of rapidly progressive BOOP, diagnosed by open lung biopsy and showed a reluctant response to corticosteroid.

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Cynomolgus Macaque Model for COVID-19 Delta Variant

  • Seung Ho Baek;Hanseul Oh;Bon-Sang Koo;Green Kim;Eun-Ha Hwang;Hoyin Jung;You Jung An;Jae-Hak Park;Jung Joo Hong
    • IMMUNE NETWORK
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    • v.22 no.6
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    • pp.48.1-48.13
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    • 2022
  • With the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants, which are randomly mutated, the dominant strains in regions are changing globally. The development of preclinical animal models is imperative to validate vaccines and therapeutics against SARS-CoV-2 variants. The objective of this study was to develop a non-human primate (NHP) model for SARS-CoV-2 Delta variant infection. Cynomolgus macaques infected with Delta variants showed infectious viruses and viral RNA in the upper (nasal and throat) and lower respiratory (lung) tracts during the acute phase of infection. After 3 days of infection, lesions consistent with diffuse alveolar damage were observed in the lungs. For cellular immune responses, all macaques displayed transient lymphopenia and neutrophilia in the early stages of infection. SARS-CoV-2 Delta variant spike protein-specific IgM, IgG, and IgA levels were significantly increased in the plasma of these animals 14 days after infection. This new NHP Delta variant infection model can be used for comparative analysis of the difference in severity between SARS-CoV-2 variants of concern and may be useful in the efficacy evaluation of vaccines and universal therapeutic drugs for mutations.

Epidemiological Pattern of Mycoplasma pneumoniae Pneumonia from 1993 Through 2002 and Clinical Characteristics during Recent Five Years (10년간(1993~2002) Mycoplasma 폐렴의 역학적 양상과 최근 5년간 Mycoplasma 폐렴의 임상소견에 대한 고찰)

  • Oh, Kyung-Chang;Yoo, Jung-Suk;Ahn, Seung-In;Kim, Bong-Rim;Kim, Sung-Seob;Kim, Yeon-Ho;Chang, Jin-Keun;Cha, Sung-Ho
    • Pediatric Infection and Vaccine
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    • v.11 no.1
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    • pp.101-111
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    • 2004
  • Purpose : This study was performed to observe the epidemiological pattern of M. pneumoniae pneumonia during the period from 1993 to 2002 and also to see some clinical characteristics of M. pneumoniae pneumonia during recent five years. Methods : We had performed a retrospective analysis of epidemiological pattern of occurrence in 682 patients with M. pneumoniae pneumonia admitted to Department of Pediatrics of Han-il General Hospital from January, 1993 to December, 2002. Results : The annual ratio of M. pneumoniae pneumonia was compared with the total numbers of respiratory tract infection patients. The ratios were 19.1% in 1993, 13.0% in 1994, 5.6% in 1995, 12.8% in 1996, 18.6% in 1997, 22.6% in 1998, 1.1% in 1999, 13.3% in 2000, 9.1% in 2001, 6.0% in 2002, and 19.9% in 2003. The epidemics have occurred in 1993, 1997, 1998, 2000, and 2003 years showing 3~4 year intervals. The peak incidence of age was four to six years old(286 cases; 41.9%) and male-to-female ratio was 1 : 1.1. Monthly distribution showed a high frequency from August to December and the major outbreak occurred in November(119 cases; 17.4%), in October(106 cases; 15.5%), and in December(96 cases; 14.1%) in order of frequency. The most common symptoms were cough (660 cases; 96.8%), fever(569 cases; 83.4%), and sputum(522 cases; 76.5%) in that order. Leukocytosis was observed in 31.2% of patients based on a normal range according to the adjusted age. Increased ESR(${\geq}20mm/hr$) was noted in 42.5% of cases and CRP was positive in 37.8% of cases. On the chest X-ray examination, pulmonary infiltration was noted in 557 cases(81.7%), and the patterns of pneumonic infiltration were bronchopneumonia(78.0%), lobar(35.5%), lobular(19.2%), and interstitial pneumonia(28.7%). Complications were paranasal sinusitis(41 cases), acute otitis media(23 cases), pleural effusion(19 cases). cervical lymphadenitis(18 cases), and glomerulonephritis(1 case). Conclusion : The pattern of M. pneumoniae pneumonia from 1997 to 2003 noted 3~4 year interval with peak monthly distribution of October and November compared with 3 year interval and peak incidence of summer period before 1996.

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A Case Report of Patient Suffering from Cough and Dyspnea after Lung Transplantation Treated with Complex Korean Medicine (기침 및 호흡곤란을 호소하는 폐 이식 환자의 복합 한방 치험 1례)

  • Seyeon Lee;Kibeom Ku;Mariah Kim;Irang Nam;Minhwa Kim;Changwoo Han;In Lee;Jinwoo Hong;Jungnam Kwon;Soyeon Kim;Youngju Yun;Sojung Park;Junyong Choi
    • The Journal of Internal Korean Medicine
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    • v.44 no.5
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    • pp.1101-1108
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    • 2023
  • We report the case of a lung transplantation patient whose cough and dyspnea symptoms improved after receiving complex Korean medicine treatment. Lung transplantation provides a solution to many end-stage patients with lung disease who are refractory to conventional treatment, but the five-year survival rate of lung transplantation remains around 50%, and even surviving patients suffer from side effects, including infection, respiratory difficulty, and gastrointestinal problems. A 66-year-old woman with rheumatoid arthritis-interstitial lung disease was advised to undergo lung transplantation surgery when she suffered from dyspnea and failing respiratory symptoms after being diagnosed with COVID-19 and contracting pneumonia. Approximately five months after receiving a bilateral lung transplantation operation, she experienced acute pulmonary thromboembolism, and even after receiving anticoagulation therapy, she still struggled with cough and respiratory difficulty. After she received complex Korean medicine treatments, including herbal medicine, cupping therapy, and electrical moxibustion, we observed a decrease in inflammation, alleviation of symptoms such as cough and dyspnea, and improvement of pulmonary function and exercise capacity.

A Case of Hypersensitivity Pneumonitis Caused by Methotrexate (Methotrexate에 의한 약제 유발 과민성 폐렴 1례)

  • Suh, Hyun Joo;Chung, Man Pyo;Park, Eun Ha;Shin, Sung Chul;Jeon, Kyeong Man;Yu, Chang Min;Pyun, Yu Jang;Lee, Kyung Soo;Han, Joungho
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.2
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    • pp.203-209
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    • 2004
  • Background : Methotrexate (MTX) has been used to treat a wide range of malignant and benign diseases including osteosarcoma, advanced stage non-Hodgkin's lymphoma, psoriasis, severe rheumatoid arthritis, sarcoidosis, and Wegener's granulomatosis. MTX-induced lung injury occurs in up to 10% of treated patients. Although both acute and chronic presentations have been described, typical manifestation of MTX-induced lung injury is subacute with symptoms usually developing within several months after starting therapy. Nonspecific interstitial pneumonia (NSIP) is the most common histopathologic manifestation of MTX-induced lung disease, while bronchiolitis obliterans organizing pneumonia (BOOP) and diffuse alveolar damage (DAD) are less common. Granuloma formation is reported in 34.7%. In Korea, Two reports of MTX pneumonitis have been published. The one presented with NSIP and the other with DAD. We recently experienced a case of MTX pneumonitis with presentation of hypersensitivity pneumonitis.

Diffuse Infiltrative Lung Disease : Comparison of Diagnostic Accuracies of High-Resolution CT and Radiography (미만성 침윤성 폐질환의 진단: HRCT와 단순흉부X선사진의 비교)

  • Kim, Kyeong-Ah;Kang, Eun-Young;Oh, Yu-Whan;Kim, Jeung-Sook;Park, Jai-Soung;Lee, Kyung-Soo;Kang, Kyung-Ho;Chung, Kyoo-Byung
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.3
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    • pp.388-402
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    • 1996
  • Background : To compare the diagnostic accuracies of High-resolution CT(HRCI) and chest radiography in the diagnosis of diffuse infiltrative lung disease(DILD). Methods : This study included ninety-nine patients with a diagnosis of acute or chronic DILD, representing 20 different diseases. Twelve normal subjects were included as control. The disease state was confirmed either pathologically or clinically. Radiographs and CT scans were evaluated separately by three independent observers without knowledge of clinical and pathologic results. The observers listed three most likely diagnoses and recorded degree of confidence. Results : The sensitivity of HRCT in the detection of DILD was 98.9% compared to 97.9% of chest radiography. Overall, a correct first-choice diagnosis was made in 48% using chest radiographs and in 60% using HRCT images. The correct diagnosis was among the top-three choices in 64% when chest radiographs were used, and in 75% when HRCT images were reviewed. Overally a confident diagnosis was reached more often with HRCT(55%) than with chest radiography(26%). The correct first-choice diagnosis increased remarkably when the HRCT was used in usual interstitial pneumonia, miliary tuberculosis, diffuse panbronchiolitis and lymphangitic carcinomatosis. Conclusion : HRCT is confirmed to be superior to conventional radiography in the detection and accurate diagnosis of DILD. HRCT is especially valuable in the diagnosis of usual interstitial pneumonia, miliary tuberculosis, diffuse panbronchiolitis, and lymphangitic carcinomatosis.

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